Clinical and Epidemiological Characteristics of Patients with Dientamoeba fragilis Infection

Lucía Miguel Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Fernando Salvador Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Elena Sulleiro Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain

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Adrián Sánchez-Montalvá Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Daniel Molina-Morant Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Isabel López Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain

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Israel Molina Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autónoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Dientamoeba fragilis is an intestinal protozoan, usually considered nonpathogenic. However, in the last years, there has been an attempt to clarify its possible pathogenic role. We aim to evaluate the clinical and epidemiological characteristics of D. fragilis–infected patients. Adults with D. fragilis detection in feces who attended the Vall d’Hebron University Hospital (Barcelona, Spain) were evaluated retrospectively from April 2009 to March 2014. We classified the patients in asymptomatic, symptomatic without other causes except infection of D. fragilis, and symptomatic with another cause. Among symptomatic patients, treatment response was evaluated. One hundred eight patients were included. Sixty-three percent of the patients were immigrants, 29.6% were autochthonous, and 7.4% were travelers. Forty-nine (45.3%) patients presented symptoms, and eosinophilia was observed in 26 (24.1%) patients. Overall, 59 (54.7%) patients were asymptomatic, 15 (13.8%) presented symptoms which were attributable to other causes, and 34 (31.5%) patients presented symptoms with no other causes. In this last group, 29 patients received specific treatment and 65.5% of them presented a complete resolution of the symptoms. The group of symptomatic patients with no other cause had more proportion of women, more proportion of autochthonous people, and were older compared with the group of asymptomatic patients. Dientamoeba fragilis infection should be considered as pathogenic when other causes are ruled out.

Author Notes

Address correspondence to Fernando Salvador, Infectious Diseases Department, Vall d’Hebron University Hospital, P° Vall d’Hebron 119-129, Barcelona 08035, Spain. E-mail: fmsalvad@vhebron.net

Authors’ addresses: Lucía Miguel, Fernando Salvador, Adrián Sánchez-Montalvá, Daniel Molina-Morant, and Israel Molina, Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain, E-mails: lucy_zgz86@hotmail.com, fmsalvad@vhebron.net, adsanche@vhebron.net, dani.molina7@gmail.com, and imolina@vhebron.net. Elena Sulleiro and Isabel López, Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain, E-mails: esulleir@vhebron.net and maibel56@gmail.com.

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